Intervertebral disk disease, especially in chondrodystrophic dogs, requires aggressive, immediate treatment to prevent neurologic damage and loss of function. This article discusses the indications of conservative treatment consisting of 2 weeks of cage rest with corticosteroid/opioid or NSAID treatment (but not concurrently) for acute first-time occurrences of intervertebral disk disease and surgical decompression treatment for recurrent, progressive, or unresponsive disease to preserve neurologic function. Animals with motor function and deep pain sensation surgically treated within 24 hours of onset of signs have a better prognosis (= 95%) than do animals that have already lost motor function and do not have pain sensation (50% with ± 5% chance of ascending or descending myelomalacia). Positive pain response can be elicited by pinching the hind toes and observing for aggression, vocalization, or dilation of the pupils (cross-check against front toes if in doubt). Animals that have longer delays between onset of signs and presentation have a worse prognosis than animals treated sooner. This article discusses appropriate pharmaceuticals and nutraceuticals, dose regimens, substitutes, side effects, pain relief, and patient management (restraint, in this case).
COMMENTARY: This brief article provides a concise overview of intervertebral disk disease and discusses the indications of medical vs surgical treatment. It also includes a checklist of potential medical treatments and tools for determining a prognosis.
Thoracolumbar intervertebral disk disease-to the cage or to the OR? Davidson EB. VET MED: 648-650, 2003.